Hemorrhoids

Hemorrhoids are swollen veins in the anus or lower part of the rectum.

The most common causes of hemorrhoids are straining at bowel movements, prolonged sitting and pregnancy. Internal hemorrhoids occur above the anal sphincter, and external hemorrhoids occur below, outside the anal canal.

The rectum is the final portion of the large intestine. It empties stool from the body through the anus.

Causes

Hemorrhoids are very common. They result from increased pressure on the anus. This can occur during pregnancy or childbirth, and due to constipation. The pressure causes the normal anal veins and tissue to swell. This tissue can bleed, often during bowel movements.

Internal hemorrhoids occur just inside the anus, at the beginning of the rectum. When they are large, they may fall outside (prolapse). The most common problem with internal hemorrhoids is bleeding during bowel movements.

External hemorrhoids occur outside the anus. They can result in difficulty cleaning the area after a bowel movement. If a blood clot forms in an external hemorrhoid, it can be very painful (thrombosed external hemorrhoid).

Symptoms

Hemorrhoids are most often not painful, but if a blood clot forms, they can be very painful.

Common symptoms include:

Painless bright red blood from the rectum

Anal itching

Anal ache or pain, especially while sitting

Pain during bowel movements

One or more hard tender lumps near the anus

Exams and Tests

Most of the time, a health care provider can diagnose hemorrhoids by simply looking at the rectal area. External hemorrhoids can often be detected this way.

Sitz baths can help you to feel better. Sit in warm water for 10 to 15 minutes.

If your hemorrhoids do not get better with home treatments, you may need some type of office treatment to shrink the hemorrhoids.

If office treatment is not enough, some type of surgery may be necessary, such as removal of the hemorrhoids (hemorrhoidectomy). These procedures are generally used for people with severe bleeding or prolapse who have not responded to other therapy.

Possible Complications

The blood in the hemorrhoid may form clots. This can cause tissue around it to die. Surgery is sometimes needed to remove hemorrhoids with clots.